Completion thyroidectomy for differentiated thyroid carcinoma

Abstract

Completion thyroidectomy is defined as the surgical removal of the remnant thyroid tissue following procedures less than total or near-total thyroidectomy. The extent of surgical management for differentiated thyroid carcinoma (DTC) is controversial. Although some authors advocate subtotal thyroidectomy with lower complication rates, total or near-total thyroidectomy and completion thyroidectomy have been defended by others because of the improved survival and lower morbidity that is comparable with subtotal thyroidectomy. In this study, the incidence of residual tumor and surgical complication rates in patients who underwent completion thyroidectomy were investigated. The medical records of 165 patients undergoing completion thyroidectomy for DTC were reviewed. Seventy-seven (46.6%) of these patients were found to have residual tumor in the remaining thyroid tissue. Anaplastic transformation developed in two of these patients. Permanent bilateral recurrent laryngeal nerve palsy occurred in three patients, and permanent hypoparathyroidism was seen in one patient. We recommend completion thyroidectomy as an efficient and safe method of surgical treatment with a low complication rate for DTC.

Hemithyroidectomy: A Meta-Analysis of Postoperative Need for Hormone Replacement and Complications

“…However, completion surgeries are not associated with any increased morbidity in terms of postoperative complication rates [44,45]. They are comparatively safe and should be performed on all patients with indications.…”

Safety of Completion Thyroidectomy Following Unilateral Lobectomy for Well‐Differentiated Thyroid Cancer

“…The rate of complications among patients undergoing completion thyroidectomy is demonstrably higher than among those without prior thyroid surgery. 5,7,14–17 Scarring, inflammation, and bleeding in the thyroid bed make dissection and identification of important structures in these cases more difficult. Morbidity from recurrent laryngeal nerve (RLN) injury and hypoparathyroidism is not uncommon.…”

Predictive Factors of Malignancy in Residual Thyroid Tissue after Partial Thyroidectomy in Patients with Differentiated Thyroid Cancer

“…Completion thyroidectomy is recommended within 5 days after the first operation or after waiting for 3-4 months to diminish scar, inflammation, and edema [13][14][15]. In the present study, the median time to completion thyroidectomy was 5 months.…”